Friday, June 3, 2011

What do school-based occupational therapists actually do??

A few weeks ago, I got an email from a teacher for the visually impaired.  She wrote: 
I have a 3rd grade student, on grade level, totally blind, Braille reader, cane user. He is due for a 3 year re-evaluation and I have requested an OT evaluation as part of the re-evaluation. He currently receives services from a teacher for the visually impaired, orientation & mobility, adaptive physical education and from a resource teacher.  The school district’s OT is questioning why an OT evaluation would be appropriate for this child as well what services could OT provide for him? The OT has stated that OT protocol is to address handwriting and visual motor skills and thus she noted, neither intervention would be appropriate for this child. I was astonished; I have struggled for many years with this child and others on the ECC** skills and daily living skills that require fine motor (tying shoes, snapping, buttoning, zipping, etc) thus the reasoning for requesting an OT evaluation and services.”

**ECC is an expanded core curriculum addressed in Texas for children with visually impaired children.  The curriculum specifically addresses:
  • Compensatory Skills (ie: Braille, large print, access to general curriculum)
  • Orientation & Mobility
  • Social Interaction Skills
  • Independent Living Skills & Personal Management
  • Recreation & Leisure
  • Career & Vocational Education
  • Assistive Technology 
  • Visual Efficiency Skills
  • Self-Determination (Self-advocacy)

To my great frustration, this is not the first time I have heard of school-based occupational therapists stating that they only address a small range of needs such as only addressing handwriting/visual motor skills.  In school-based practice, OTs are expected to evaluate and address skills that limit the child’s ability to participate and succeed in his/her educational programming (general and special education) and his/her ability to interact with adults and participate with peers appropriately and be on par with his peers (abled and disabled).  Clearly in this situation, the OT totally ignored the expanded core curriculum that is part of this child’s educational programming. 

I recommended to my friend that she remind the school district OT that most school-based OTs address fine motor skills which encompass a wide range of functioning including shoe tying, manipulation of fasteners, etc. and remind this OT that this child has an expanded core curriculum that clearly falls within the skills and training of the OT to evaluate and address.  The best assessment tool for this instance would probably be the School Function Assessment (see as it considers the full range of skills (educational, social and functional) required of children at school and is so helpful in planning appropriate interventions. 

At any rate, I do hope this information helped that teacher.  Have you experienced similar situations in which an OT colleague has limited the scope of practice to the degree that children, their teachers and families are not being served?  Please share your thoughts in the comments section.  J


  1. Enjoyed your discussion of the various sensory processing evaluation tools. I am still looking for the one that fits best with a low functioning population. On another note, I have been collaborating with an SLP and ESE teacher and we have started a blog outlining our activities. Would love for you to take a look at it and give us your thoughts. We are at